How Are Workers’ Compensation Benefits Paid?

How Are Workers Compensation Benefits Paid

Illnesses or accidents in the workplace are situations that employers try so hard to prevent, and it’s a nightmare experience when they do happen. The problem doesn’t end there, though.   After the incident, employers then have to deal with the complex process of workers’ compensation, which could be overwhelming at times.  

When handling workers’ compensation, the goal is not to get caught up with the hassles of the claims process, so you can focus on your employee’s recovery, making sure that they get the proper treatment they need.  

This article will help you understand workers’ compensation claims, how benefits are paid, and how you can utilize a medical provider network that will not only help you navigate the entire process, but also reduce the costs related to the claims.

Workers Compensation Claims Process In A Nutshell

Workers’ compensation claims process can differ from state to state, but this is how it works generally:

  1. When employees get sick or injured while at work, they report it to the employer.
  2. The employer then provides all of the necessary paperwork for the employee to fill out.
  3. The employer then files the workers’ compensation claim.
  4. The insurance provider will either approve or deny the claim.
  5. If the insurer approves the claim, the employee will receive the benefits, but the employee can appeal the decision if the insurer denies the request.

Medical Benefits

When a workplace accident or illness occurs, the medical benefits begin immediately, especially during emergency cases.  The employer, the insurance provider, or the state will pay for the injured employee’s medical bills even before the claim has been filed.  

Non-Medical Benefits

All other workers’ compensation benefits – temporary or permanent disability benefits, will begin only after the claim has been formally accepted.  Once the treating physician certifies that the injured employee is unable to work in the meantime, the employee will automatically be entitled to cash workers’ compensation benefits such as temporary disability payments or time loss compensation.

While the employee cannot come to work, they will receive a weekly benefit equivalent to a portion of their salaries, on top of the temporary total disability benefits equivalent to two-thirds of the employee’s regular pay.  After some time, if the doctor determines that the employee has recovered and is physically capable of returning to work, only then will the temporary disability benefits cease.  

Workers’ Compensation Settlements

Instead of accepting the insurance company’s offer, the injured or sick employee can choose to negotiate with the employer for a workers’ compensation settlement to close out the case.  In return, the worker will receive a lump-sum payment.

The Workers Compensation Provider Network Advantage

It’s been established earlier that both employers and employees need to follow the correct workers’ compensation claims process, which involves many complicated steps.  Working with a workers compensation provider network frees employers of the burden of the whole process, allowing them to focus on the recovery of their injured or sick worker.

A medical provider network will schedule patients for diagnostic tests or PT and take charge of the coordination, scheduling, reporting, and billing.  They will also manage medical costs for payers by providing fair rates and prompt, accurate claims.

When the workers’ compensation claims process becomes too much to handle, Direct Pay Provider Network can make things easier for you and your injured employee.  We will make sure that they get all the treatment they need and bring them back to work as soon as they can, all while minimizing your costs.  Call our toll-free scheduling line (866) 214-5920.